MACRA Monday: Elder maltreatment screening

Publish date: November 20, 2017

If you haven’t started reporting quality data for the Merit-Based Incentive Payment System (MIPS), there’s still time to avoid a 4% cut to your Medicare payments.

Under the Pick Your Pace approach being offered this year, the Centers for Medicare & Medicaid Services allows clinicians to test the system by reporting on one quality measure for one patient through paper-based claims. Be sure to append a Quality Data Code (QDC) to the claim form for care provided up to Dec. 31, 2017, in order to avoid a penalty in payment year 2019.

Consider this measure:

Limelight Video

Measure #181: Elder Maltreatment Screen and Follow-Up Plan

This measure aims to capture the percentage of patients aged 65 years and older who have a documented elder maltreatment screening and a follow-up plan, if appropriate.

What you need to do: Screen your elderly patients for maltreatment using an Elder Maltreatment Screening tool during the visit and if they screen positive, develop and document a follow-up plan at the visit.

To get credit under MIPS, be sure to include a QDC that shows that you successfully performed the measure or had a good reason for not doing so. For instance, G8733 indicates that an elder maltreatment screen was documented as positive and a follow-up plan was documented, while G8734 indicates that the screen was negative and a follow-up plan is not required. Use exception code G8535 if the screening was not documented because the patient is not eligible. For example, a patient is not eligible if they require urgent medical care during the visit and the screening would delay treatment.

CMS has a full list measures available for claims-based reporting at qpp.cms.gov. The American Medical Association has also created a step-by-step guide for reporting on one quality measure.

Certain clinicians are exempt from reporting and do not face a penalty under MIPS:

Those who enrolled in Medicare for the first time during a performance period.

Those who have Medicare Part B allowed charges of $30,000 or less.

Those who have 100 or fewer Medicare Part B patients.

Those who are significantly participating in an Advanced Alternative Payment Model (APM).